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See Inside March 2007

Tough to Swallow

Look out stomach, here it comes
Steve Mirsky



FRANK VERONSKY
"Sword swallowing is said to be dangerous." Thus begins a short report in the British Medical Journal of November 5, 2005. One danger, according to the report's author, radiologist Brian Witcombe, was a death sentence. That outcome occurred during the Inquisition, when sword swallowing was associated with mysticism and mysticism was associated with execution. Imagine shoving a long metal blade down your throat being the highlight of your day.

Although one might assume that sword swallowing carries serious medical risks other than capital punishment, "few deaths related to sword swallowing have been described," according to Witcombe. "A Canadian sword swallower did die, but that was after swallowing an umbrella." As is well known, it is bad luck to open an umbrella inside.

The 2005 article notes that anecdotal accounts of injuries had circulated throughout the sword-swallowing community but that a detailed analysis of common risks associated with the practice remained to be delineated by the medical community. That gap in the scientific literature has now been filled. Witcombe and co-author Dan Meyer, the executive director of Sword Swallowers' Association International (SSAI), performed a survey among sword swallowers, published in the December 23, 2006, issue of BMJ. The article includes an eye-and epiglottis-catching photograph of "one of the authors" swallowing seven swords simultaneously (which prevents him from saying that three times fast) and then helpfully identifies that author as being Meyer rather than Witcombe.

Anyway, Witcombe and Meyer contacted 110 SSAI members and got usable responses from 46 individuals who had together swallowed more than 2,000 swords in the previous three months. The authors "excluded cases in which injury was related to swallowing items other than swords, such as glass, neon tubes, spear guns or jack hammers."

One common complaint was sore throats, known in the community as, of course, sword throats. Less frequent but more serious problems included perforations of the pharynx or esophagus, which would be the very definition of an occupational hazard. One individual, perhaps trying to work up to the full-size sword, wound up having "a bread knife removed transabdominally." Which easily beats having a bread knife inserted transabdominally.

"Some experienced artistes add embellishments that increase danger," the authors write of the sword-swallowing elite. "One sometimes performs on a unicycle." Which could eventually lead to the best flat tire story ever. Another swallower works underwater, in what may be a futile attempt to whet the blade.

Actually, a little lubrication is key to the entire ?p?e ingestion enterprise. "The clean sword is usually lubricated at least with saliva," the authors say. "One performer used butter," clearly unaware of the health dangers of saturated fat. "One had to retire because of a dry mouth caused by medication." Look for litigation if the medication did not include "may end career as sword swallower" in the list of possible side effects.

Although the medical literature has, until now, featured only scattered case reports of sword swallowing-related injury, sword swallowers in fact played an important role in medical history. "For example," Witcombe wrote in the 2005 BMJ paper, "a sword swallower helped Dr. Kussmaul of Freiberg to develop a rigid endoscope in 1868 using a straight tube, mirrors and a gasoline lamp." So thanks to sword swallowers, doctors learned how to shove things down a patient's throat other than the bill.

Speaking of which, the 2006 article points out that although no SSAI members have died for their art, they might have succumbed when opening their medical bills, which in one case reached $70,000. Well, you try getting insurance after putting down "sword swallower" for occupation on your application.

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